This Article Full Text (PDF) Submit a scholarly reply Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Angle, P. J Articles by Lie, L. M. Search for Related Content PubMed Articles by Angle, P. J Articles by Lie, L. M.

EXPLORING LABOUR PAIN MEASUREMENT

Departments of Anesthesia, Obstetrics & Gynecology and Nursing, Sunnybrook & Women’s College HSC, 76 Grenville Street, Toronto, ON, M5S 1B2, University of Toronto; Kunin-Lunenfeld Applied Research Unit, Baycrest Centre for Geriatric Care, 3650 Bathurst Street, Toronto, ON, M6A 2E1; Dept of Clinical Epidemiology and Biostatistics, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4L8; Dept of Anesthesia, Toronto East General Hospital, 825 Coxwell Ave, Toronto, ON, M4C 3E7; North York General Hospital, 4001 Leslie Street, Toronto, ON, M2K 1E1

INTRODUCTION: Labour pain (LP) measurement in neuraxial analgesia (NA) trials currently treats LP as if it were a single discrete pain form. Failure to account for the true nature of LP and variability in pain patterns leads to information loss. We report preliminary findings related to LP in parturients with and without NA. This information represents the first step in developing the Labour Pain Scale, the first major scale of the Quality of Labour Analgesia (QLA) Index.

METHODS: Qualitative descriptive methods were used to explore LP. After REB approval, a purposeful sample of native English speaking parturients of mixed parity, racial, socioeconomic status and delivery mode (with and without NA during labour) was recruited from 3 urban (1 teaching, 2 community) hospitals with a combined delivery rate of >10,000/year. Indepth interviews were held in hospital using semi-structured interviews. Women without any form of analgesia were interviewed 24hrs after delivery. Partients receiving NA were interviewed 24hrs postpartum or (when possible)using a 2 stage interview process (during labour after NA followed by a second interview 12 hours postpartum). Parturients were asked to colour pain patterns on 4 anatomic diagrams(depicting relevant anatomy) for each of 4 labour stages and to designate relevant pain descriptors (provided on the pain picture) for each pain type. Pain was ranked (least to worst intense) by location for each stage.

RESULTS: 31 parturients were recruited (10 had no analgesia of any form, 21 had NA.). Pain was most easily described by location (uterine; backpain; vaginal, rectal pressure ± nerve pains) rather than pain descriptors. Common qualitative pain descriptors for each location were identified. Locations varied over time and were variably present between parturients. Patients were readily able to rank pain severity by location at each. Some pain forms were constantly present (eg back pain; rectal pressure) in some parturients. Prominent patterns varied with eventual mode of delivery.

DISCUSSION: "Labour pain" consists of multiple pain forms which are variably present in location and severity over time, vary in occurrence between parturients and are readily characterized by location. Meaningful labour pain measurement must address these findings.

This article has been cited by other articles:

				P. Angle, A. Kiss, J. Yee, S. Halpern, and Y. Murthy 26225 - THE NEW LABOR PAIN SCALE (LPS):DESCRIPTION & PROPERTIES Can J Anesth, June 1, 2006; 53(suppl_1): 26225 - 26225. [Full Text] [PDF]

This Article Full Text (PDF) Submit a scholarly reply Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Angle, P. J Articles by Lie, L. M. Search for Related Content PubMed Articles by Angle, P. J Articles by Lie, L. M.